U.S. Surgeon General Richard Carmona warned of the dangers of tobacco yesterday during a visit to Hawai'i, standing with state officials as they previewed two new TV spots about the health risks of secondhand smoke.

Vice Adm. Carmona, who spoke to students at Ka'iulani Elementary School also, said the United States spends millions of dollars each year to combat health problems from tobacco that are preventable. In Hawai'i, as many as 1,100 people die annually from tobacco-related illnesses; tobacco causes an estimated $565 million in healthcare costs and lost productivity.

"Not only does it rob you of your life, it robs you of the quality of your life," Carmona said at a news conference at the state Capitol with Gov. Linda Lingle, Lt. Gov. James "Duke" Aiona and state Department of Health director Chiyome Fukino.

Hawai'i is the third lowest in the nation, behind Utah and California, in the prevalence of tobacco use. Lingle and Aiona, both heavy smokers when they were younger, said the state's effort would continue to focus on prevention to discourage young people from smoking.

"As a former smoker myself, a heavy smoker until 20 years ago, I know how difficult it is to quit smoking," Lingle said. "It's one of the most difficult things people ever do in their lives, and any former smoker will tell you that."

The two television spots, to begin airing next week, involve testimonials from people who believe they have suffered from exposure to secondhand smoke. Dr. Paul Ho, a cardiologist who does not smoke, believes the heart attack that exposed his heart disease was linked to the secondhand smoke he encountered at a nightclub. Kathlyn Loughlin, a nonsmoker, believes her pulmonary disease was caused by being near the smoking of her late husband and father.

Loughlin, 69, who lives in Waikiki, said she still swims two hours a day but is not as active as she was before her illness. "Things I used to enjoy doing I can no longer do," she said.

The TV spots are being paid for through the state's share of a nationwide settlement with tobacco companies. Hawai'i received a "D" grade from the American Lung Association for not spending more money from the settlement last year on tobacco prevention and control, while most states got an "F." The Islands received a higher grade, a "B," in protecting the air with strong county restrictions on smoking in the workplace.

Several bills at the state Legislature target tobacco, including a statewide ban on smoking in the workplace or public places to reduce the risk of secondhand smoke. Other bills would increase the cigarette tax to pay for cancer research and disease prevention and prohibit the sale of flavored cigarettes that may be marketed to teenagers.

Deborah Zysman, director of the Coalition for a Tobacco Free Hawai'i, said the statewide ban on smoking in the workplace and public places would provide some consistency to the patchwork of county laws. "We have this inequality. Some places have great protections for workers. Some not so much," she said. "We're just trying to fill in the pukas."

Reach Derrick DePledge at ddepledge@honoluluadvertiser.com.